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October 31: Today on TownHall Karla Arzola, Chief Information Officer at Rocky Mountain Human Services speaks with Priscilla Frase, MD, CMIO and Hospitalist at Ozarks Healthcare. Priscilla shares her insight into the optimization of Ozark’s MEDITECH Expanse systems to boost patient care and quality. Drawing from her journey on transitioning from traditional paper records to electronic health records, she paints a vivid picture of the role of technology in modern health care. How can we improve EHR satisfaction across various organizations using the same system? What role does user mastery play in the fluctuating satisfaction levels and how can this be addressed? How does she approach optimizing providers' use of the EHRs?

Learn more from Dr. Frase’s Blog Post: How personalizing Expanse unlocked new opportunities for patient care at Ozarks Healthcare. And, read about additional organizational success as Ozarks Healthcare Expands Behavioral Health Services With MEDITECH Expanse.

Dr. Frase is a 2024 HIMSS Changemaker in Health Awards finalist. Voting is open until 11/28 at 12:00 PM CST/ You can vote for her here.

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Today on This Week Health.

A physician will text me and say, hey, I would really like this within the system. I spend a few minutes talking to our IT staff, or I just play around in the system myself. Figure out that I can do what they want very quickly, and then that afternoon, be able to produce it for them in the EMR, and get those small wins whenever we can, and I think that really helps keep them engaged.

Welcome to Town Hall, a show hosted by leaders on the front lines with interviews of people making things happen in healthcare with technology. My name is Bill Russell, the creator of This Week Health, a set of channels and events dedicated to keeping health IT staff current and engaged.

We've been making podcasts that amplify great thinking to propel healthcare forward for over five years, and we want to thank our show sponsors. who help to make this happen. Armis First Health Advisors, Meditech, Transcarent, and UPerform. We thank them for investing in our mission to develop the next generation of health leaders.

Now, on to our show.

Hi everyone, welcome to one more Townhall episode of This Week Health. Today we'll be talking to Dr. Frase. She is the CMIO Ozarks Health, and she has been their physician champion since she started in 2014. She is highly knowledgeable in Meditech and she has facilitated the optimization of their EHR system to improve patient care and quality since she's been there.

And so, hi, Dr. Frase, thank you for joining us.

Hi, happy to be here.

Awesome. Would you like to add or share something else about your background or your role Ozarks?

Yeah, I can do that. I got into IT kind of accidentally. When I first transitioned from paper to electronic records, I had a horrible personal experience as a physician and honestly avoided EHRs at all costs.

And when it became evident that I couldn't avoid them, I ended up taking on a role as a physician educator for HCA. During their initial CPOE go live education, go lives and I did it so that I could get educated the most that I possibly could be for myself, but also to be able to help my colleagues with it.

And I worked on HCA CPOE go lives for quite a few years. And when I ended up coming to Ozarks Healthcare, that ended up transitioning into the CMIO role, and I've been learning as I've gone along, but always get back to my own personal experiences using the EHR to help me help my colleagues, and it's been a quite a journey here at Ozarks Healthcare.

Yeah, and I have to say, as a technologist, we always need partners, and it's so important that we have champions such as yourself helping us drive those implementations because we all know that. Technology is not an IT project. It's, we are the facilitators and you guys are the ones that own the system and the implementators and the ones that are going to drive success.

So I appreciate that. That is, That is good to hear. And I'm glad that I have somebody like you on our side. And so, let's talk about you recently went to the KLAS Arch collaborative meeting in July. And I understand you're an active member. And so this group meets every year and is an organization committed to improve EHR experience.

And so there were tons of leaders. I was reading there was approximately about 300 people, a hundred or over a hundred organizations that attended. And so what would you say was the underlying message you believe everybody took with them during this event?

The ARCH Collaborative is all about EHR satisfaction, and that's for providers, nursing staff, but it's, it's just about getting the best that you can out of what you have with it all.

And within the ARCH Collaborative Summit every year, I get rejuvenated about different ways that we can do things. It's a lot of, it's the same stuff. It's providing good initial education and good ongoing education for the EMR. You're never done, but you always need to be reminded of the simple ways that you can do things better for your own providers to get the most out of what you have.

Some of the things that I was reading is you can have a system, same system across multiple organizations, and everybody uses differently. And the outcome on physician satisfaction is Completely different, right? There could be even 60 percent difference in physician satisfaction. So what are some of the things that you've seen from that perspective?

Getting to some of Arch Collaborative's biggest principles, user mastery with it, shared ownership within the system, and being able to personalize it. Those three variables account for over 70 percent of the variabilities that you see. When 2 different organizations are on the same EHR, the providers at each of those organizations just had different experiences with those 3 elements of what they experienced during the EHR implementation, whether that be in a new implementation of an EMR or with their just general onboarding when they come on to the organization for the 1st time.

And getting to the place that you can bring everybody up to the same level. We all only use certain percentages of our EHR. If we can get to where we're using 100 percent of that EHR to its full benefit, then we can all get to the same place with it. And using the evidence-based guidelines and best practices that ARCH Collaborative has come up with with data collected from several hundred organizations and many thousands of providers over time gives you a foundation to build on at your own organization without having to recreate a wheel that other people have already tried to put together.

Yeah, that's so important. And, I don't know if I don't know if you know this about myself, but I'm an industrial engineer, right? So for me, it's always every time that we implement something, it's not just about doing it just that one time, you always have to go back and change and modify and, and tweak, you know, what you've done, look at your workflows, is that applicable?

Is that not anymore? And so very important that you keep, you know, that you keep it going. And I feel like that is one of the biggest challenges that we have in healthcare. Sometimes we give so much technology to our clinicians and then we fail, right? To go back and say, is it working the way we intended it to work?

What are the outcomes? Can we measure them? And then start making modifications from there on. But so in your experience what has been the most effective method to improve physician satisfaction and to get the buy in, right? Because, I mean, again, you have those physicians who are going to be extremely resistant to change, and not just physicians, but just clinicians in general.

So what has been your method


far? Yeah, I think for us in particular, the focus on the training with everything between our transition from previous EMRs to Meditech Expanse, we improved our provider satisfaction from the 15th percentile for all ARCH collaborative providers to the 84th percentile for all ARCH collaborative providers, just with a focus on training and setting guidelines for training, minimum of six hours of training With that training, it's a combination of online learning at the elbow support.

We also introduced whole clinic training for our ambulatory providers, where it's not just the physician getting trained. It's their nursing staff. It's their MAs. It is their registration staff. It's their coders and billers so that everybody's on the same page with everything. A focus on getting into the personalization aspects of the EMR also is a big deal.

To help with that provider buy in and using specialty specific workflow scenarios in the training so that you're focusing on those things that individual provider needs rather than just generic EHR stuff so that they get pulled in with that workflow and can not only learn what we've. Suggested, but provide information to us about ways to make it better so that we're always having that check back in with how things are working.

Having follow up time designated a few weeks later. We do initial training with our IT trainers and then I get involved a couple of weeks later when the physicians have had time to. process what they've learned and see the things that they want to do more with. And then I can, at a point that they're engaged and want to learn about the personalizations, be able to tell them how they can make their summary and reference regions be what they want to see for that patient at that time.

Show them how to get their documentation typicals and how they can get their personalized order sets within the system to make their workflows more easy for them to get through their days efficiently. And I think Having that support from leadership for my role to be able to do that helps with keeping providers satisfied.

I hear from other organizations all of the time that not having a me at their organization makes it harder for them to achieve the same thing. So, having physicians that are willing to participate to help train physicians and listen to physicians and act on what they could benefit from. 📍

  📍 We'll get back to our show in just a minute. With Meditech Expanse, you'll have all the tools that you need to keep people at the center of care. Engage your patients, reduce clinician burnout, explore innovative care delivery models, and leverage precision medicine and advanced decision support to make informed decisions.

CY Expanse quickly ascended the class rankings to become one of healthcare's top overall software suites. Visit ehr. meditech. com to learn more. And now, back to our show. 📍

 Yeah, you're absolutely right.

I remember back in the day I did an implementation on outpatient setting for an EMR and we were lucky enough to have a physician champion and we selected a physician champion for each of our specialties. Again, like you said, I mean, you don't. You don't, cause you can't do like a one EMR fits everybody's needs, right?

But you can't also make it so you feed everybody's needs too, because then you get into the very specialized workflows or into the very customized and then to get out of there is so difficult. And so from your perspective as well, so you get the physician's trained and then you get them engaged through the process to make sure that they're, happy with what they're doing and that they're, effective.

But how do you keep that communication with them? How do you ensure that you keep that momentum and, you know, that you continue to collaborate?

Yeah, that is always a challenge to keep that momentum going, particularly with changes in healthcare overall, those ups and downs that we all experience at our own organizations.

But for me, it's about staying focused on Making it about providing safe, quality patient care and that patient-centered experience, but without overburdening the providers. And so keeping the emphasis on that, all of us physicians want to provide the best possible care to our patients, the best possible relationships with our patients.

And if I can stay focused on those things and find ways to minimize the burden within the EMR to accomplish that, it makes it. Better I participate quite heavily in all departmental meetings within the organization. So I'm always there for the providers from that perspective. I provide updates on what's going on.

I do send out emails. They're not often read. So I also get people on the floors rounding with them. I hang out in the doctor's lounge. Grab people for five minutes while they're at work. Yesterday, I met with one of the orthopedic physicians on something I've been wanting to show them for a while. Like, they've asked for something, get with them, show them what we created for them.

A physician will text me and say, hey, I would really like this within the system. I spend a few minutes talking to our IT staff, or I just play around in the system myself. Figure out that I can do what they want very quickly, and then that afternoon, be able to produce it for them in the EMR, and get those small wins whenever we can, and I think that really helps keep them engaged.

They realize if they share feedback with us, and we act on it, when we can get results back to them very quickly, they know that for those things that take longer, we're going to be working on that as well. And that constant communication and being a peer with them where I'm seeing patients and they know I'm not just in a administrative role only they know I'm going through the same things, I have the same challenges, and so they're not afraid to share with me what they would like to see better.

I can't fix it all, but the things that I can improve for them, I act on it in a timely fashion as I'm able to, sometimes with new expenses, but most of the time just with reworking what we already have and providing education and reinforcement for it. Yeah,

so going back to the event, right? It's about sharing those common practices and not reinventing the wheel.

And I'm sure we all have the same challenges. I mean, and we're not unique in even though we feel like, oh, my God, we're different. We have this. It's not true. It's not, you know, we all been through the same. And there's some things yeah some experiences that we can share and leverage. Thanks.

So you have this unique role, and like I mentioned before, yes, CMIO is one of those roles that has been extremely key for the success implementation, not just of an EMR, just any technology that you want to put on the floor, right, or that you want to implement in the organization. Your role is unique because you're, are you, you know, you're bridging the gap between leadership, like you mentioned, you know, it is not just about, you know, I'm a leader in the organization and then you're talking to the information technology, the technology departments.

So how do you, manage those relationships? Right? How do you bridge those gaps between those groups? And I know you mentioned a few things, but what else can, can we do?

Yeah, for me as a CMIO, it's not just about focusing on what the providers do. It's I actually, over time, have become well versed in pretty much every module within our EMR.

I am actively involved in patient safety committees, patient Quality, I'm actively involved in revenue cycle. I work on coding education. I'm a utilization review physician. I wear a lot of hats and part of that's because I'm at a small independent rural health care organization, but wearing all of those different hats helps me see different ways of being able to improve things.

When one department says, if we just had this one click in the system, we'd get all these other things. I can look at it and go, you know what? We don't even need to click. We just need to put something in the background that will automate that. Then everybody's happy. Nobody has to do anymore. And it all makes more sense on all aspects of it.

We can meet those regulatory, financial, quality, patient-centered care needs without changing anything other than the background stuff. And I think that's Part of it, for me, one of the most exciting aspects of what I do is having that breadth of knowledge across multiple areas, not just providers, but in all elements of it, all care team members.

I work with the case managers, the nursing staff, administration, wherever there's a problem, think about it and think about what aspects of the technology that we have at our disposal we can harness to make those workflows better for everybody.

So I do

have to ask you, how do you bring IT into the table, right?

Because you're talking about the leadership, obviously you can a hundred percent communicate with 'em. 'cause you understand, again, you take care of patients as well. Mm-hmm. ,, so what about the team and your IT partners. How do you bring them into the conversation so they can align to what your

vision is?


think I've kind of become sort of the go to for a lot of our applications analysts. They run things by me. Is this an approach we can use? Yeah, I think that would be great. Hey, let's talk to this department, pull this in, get that feedback so that we're not working in a siloed IT environment.

I'm kind of that bridge between all the other parts of the organization that need to have input into that say. I'm also the person that can say to The staff, hey, I really could use your benefit to put come in and help us figure this workflow out for this other side of the organization and having that voice and all meetings where I have an opportunity to share those things.

I can translate the IT world. into all of those other departments and vice versa. Take the things from the other departments and translate it into IT terms for the IT side. Whether that be infrastructure or the applications team, I can try to bridge all of that. And that is something that's needed because everybody speaks different languages, has different comfort levels with what they know.

Some people are clinical, some people are not clinical, but getting it all to make sense to the other side of the equation. Yeah.

Well, yes that's extremely good advice. So what is next for Ozarks Healthcare?

Oh, we have a lot of projects on the table. We've recently implemented CommonWell and are working on optimizing the workflows for that with Health Information Exchange with other organizations, trying to find ways to bring in meaningful information with the least burden to providers within the organization.

Getting patients engaged with registering with that as well. That's a challenge here in southern Missouri. We are working on sepsis toolkit implementation to improve our sepsis quality metrics as well as looking at the revenue cycle side of all of that. 1 of the things that I'm most excited about that we're doing right now is we have.

Worked with Zynx to pull in some ambulatory order set content. We've had order set content that was evidence based in the inpatient setting, but bringing that into the outpatient world. And that's been an ask from our providers for a long time, and the project is going very well and very well received.

And it's nice because it's something that the providers have wanted, and the technology benefits of that are being seen right away. I would put one new order set into the system last week, and the providers love it. With one click, they can order all. All of the patient's diabetic supplies and things like that really are a help for all of them.

Patients get everything that they need because the providers don't have to remember to order each individual thing and the order. The other order sets that we're working on are all evidence based. So, it kind of keeps within what we want to do for our patients and providing that high level consistent.

Care that is evidence based rather than just individual provider making decisions about things without that evidence in there. We also are working on patient engagement products to get patients more involved, working on bridging that divide between technology within our community and getting mobile apps and applications for our providers within the organization to be easier on the go wherever they are, in the hospital, in their clinics, to be able to access the system.

And we're venturing a little bit into AI stuff with a pilot project for, with DAX CoPilot, and I'm looking forward to that. As a small organization, we need to be able to keep up with all of the larger organizations as well that have more resources um, and have different payer mix than we do but we're still able to do those same things and try to find the best ways to make everybody happy in the end of it.

And I think just... Continuing to learn how to be masters of change. It's not becoming so much a master of the EHR, but a master of the change because the EHR is always going to be changing. What we're doing in healthcare is always changing and finding those items within technology that are worth the expense to yield positive outcomes and balancing that with refining things that we already have to where they're optimized to their fullest without added expense.

And today's financial situation within healthcare is kind of. Kind of what I see the biggest things on our front right now.

Yeah, I know. And I'm glad that you mentioned that because that's key, right? When do we introduce technology? Does it make sense? Is it going to produce a positive outcome in any sort of way?

And is the organization ready for it? So it seems like you guys have a ton of stuff going on, but you've been waiting for it and you're ready for that change. And so that's super exciting to hear anything else that you want to share with our audience before. Yeah,

I think the other thing that we also have on the table is a repeat ARCH collaborative survey.

I really value the input from that. If we don't get information that we can benchmark against other organizations, we don't know how we're doing because all we live in is our own world. And that data is really imperative to help us refine What we need to be working on where we don't measure up to other organizations and to hear the voice of our providers and our end users on what they want the most and what they think will benefit them the most.

The other thing I'll say is that we all think that people don't want more training. But they do within our organization, we had 40 percent of our providers wanted more training than what they, what we had already provided them. And that's with requiring a minimum of 6 hours of education for every provider at GoLive and ongoing training every year and remembering that and not thinking that people don't want what you can easily give them is super important today.

Well, thank you. Thank

you for that. Thank you for sharing the space with us. And , so nice to meet you and looking forward to hear about the outcomes of your new initiatives.

Thank you very much. I'm excited to see where we get with with more participation with the ARCH Collaborative and MEDITECH, too.

Yeah definitely can't wait to hear. And you're probably going to be sharing a lot of more, a lot of the outcomes that you're getting with your new implementation on the next event. So, looking forward to talk to you and thank you again. Thank you. Bye bye. Take care.


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